摘要
目的探讨超声造影(CEUS)与常规超声对海绵状肝血管瘤(HCH)的诊断效果,以为临床应用提供依据。方法采用随机数字表法选取疑似海绵状血管瘤患者222例,对其临床资料进行回顾分析。患者均经CEUS检查和常规超声检查。观察比较患者经不同诊断方法检查的准确度、特异性、灵敏度、漏误诊情况等。结果临床病理检查确诊165例为海绵状肝血管瘤。CEUS检查准确度96. 80%,灵敏度97. 60%,特异度94. 70%;Kappa值0. 918,与病理诊断一致性好;常规超声准确度、灵敏度、特异度分别为83. 80%、84. 80%、80. 70%,Kappa值0. 607,与病理诊断一致性差;上述指标组间比较,P <0. 05。165例确诊患者病灶总数170个,肝脏左、右两侧分别65个、105个。CEUS检查出163个病灶,低回声病灶15个,在血管瘤内形成血栓、钙化;误诊、漏诊率分别为3/222(1. 35%)、5/222(2. 25%),总发生率8/222(3. 60%);误诊者均为肝囊肿。常规检出病灶144个,低回声、高回声病灶分别130个、14个;多发病灶89个(61. 81%);误诊率、漏诊率分别为10/222(4. 50%)、25/222(11. 26%)、35/222(15. 77%);误诊者8例是肝癌,2例肝腹水。两组漏诊者均系病灶不典型。结论 CEUS对海绵状肝血管瘤的诊断效果较佳,可通过提高诊断准确度、灵敏度特异度,对海绵状肝血管瘤进行有效筛选。
Objective To explore and analyze the diagnostic effect of contrast-enhanced ultrasonography (CEUS) and conventional ultrasound in the diagnosis of Hepatic cavernous hemangioma (HCH),so as to provide evidence for clinical application.Methods A total of 222 patients with suspected cavernous hemangioma diagnosed and treated were randomly selected for retrospective analysis of their clinical data.All patients underwent CEUS examination and routine ultrasonography.We observed and compared the accuracy,specificity,sensitivity,misdiagnosis and satisfaction of different diagnostic methods.Results A total of 165 cases were confirmed as cavernous hemangioma by clinicopathologic examination.The accuracy,sensitivity and specificity of CEUS were 96.80%,97.60% and 94.70% respectively;the Kappa value was 0.918,which was in good agreement with pathological diagnosis;the accuracy,sensitivity and specificity of conventional ultrasound were 83.80%,84.80%,80.70% respectively;the Kappa value was 0.607,which was poor consistency with pathological diagnosis.The above indexes were compared,P<0.05.The total number of lesions in 165 confirmed patients was 170,and the left and right sides of the liver were 65 and 105 respectively.CEUS detected 163 lesions and 15 hypoechoiclesions,which formed thrombosis and calcification in hemangioma.The rates of misdiagnosis and missed diagnosis were 3/222 (1.35%) and 5/222 (2.25%),respectively.The total incidence was 8/222(3.60%);misdiagnosed were all liver cysts.The 144 lesions were routinely detected,130 and 14 hypoechoic and hyperechoiclesions,and 89 (61.81%) with multiple lesions.The rates of misdiagnosis and missed diagnosis were 10/222 (4.50%) and 25/222 (11.26%,respectively),35/222 (15.77%);8 cases of misdiagnosis were liver cancer and 2 cases of liver ascites.The missed patients in both groups were atypical.Conclusion CEUS has a good diagnostic effect for cavernous hepatic hemangioma,which can be effectively screened by improving the diagnostic accuracy,sensitivity and specificity.
作者
曹东明
林陪任
陈荣华
许泽茹
Cao Dongmin;Lin Peiren;Chen Ronghua;Xu Zeru(Department of Ultrasound,People's Hospital of Wenchang,Wenchang 571300,China)
出处
《中国临床保健杂志》
CAS
2019年第3期386-388,共3页
Chinese Journal of Clinical Healthcare
基金
海南省医药卫生科研项目(15A200045)
